According to a recent study published in European Psychiatry, a combined treatment, including cognitive behavior therapy (CBT), psycho-education, and pharmacology results in greater long-term efficacy in patients with refractory bipolar disorder than standard pharmacological treatment.

The current study is a 5-year follow-up to a previous trial which examined the differences in efficacy for patients (n=40) with treatment resistant bipolar disorder who were randomly assigned to an experimental group that used a combined therapy, or control group that used pharmacology alone. There were multiple evaluation points (6-months, 12-months, and 5-years) and at each follow-up, the between-group differences remained significant.

At all follow-up points, the combined therapy group had lower depression and anxiety scores. They also showed significant differences in mania and maladjustment at post-treatment, which were sustained through the 6-month, 12-month, and 5-year evaluation points. Further, the experimental group had fewer hospitalizations at the 12-month evaluation point. At the 5-year follow-up, 88.9% of patients who received pharmacological treatment alone continued to show persistent affective symptoms and/or difficulties in social-occupational functioning, compared to just 20% of patients who received the combined therapy treatment.

These findings suggest that a combined therapy, including CBT, psycho-education, and pharmacology may be quite helpful for patients with refractory bipolar disorder in the long term and superior to pharmacological treatment, alone.